By Dr. Amy Jones, D.O., OBGYN
OK, NEWS FLASH: Men and women have different anatomies, each special in its own way, of course. One very special part of the male anatomy is the prostate. So let's take a moment to give praise to this rock star of a gland!
Let’s drill down on the prostate, shall we?
The prostate gland has an important job: It produces a thick, milky-white fluid that becomes part of the semen, the liquid ejaculated during sexual activity. The gland isn't big, it is about the size of a walnut and sits at the base of the penis. It wraps around the urethra (the tube that urine comes out of from the bladder). It’s located just below the bladder and in front of the rectum. That means prostate problems can affect urination and sexual function as men age.
For reasons still unclear, the prostate continues to grow bigger as a man gets older and this is the cause of the urination issues that occur in half of all men by age 60, and in almost all men by age 80. A fancy term for its enlargement with age is benign prostatic hypertrophy (BPH). I know what you’re thinking ... why couldn’t the penis enlarge and the prostate shrink? Nature can be cruel.
As men age, trips to the restroom become annoyingly frequent. And to add insult to injury, while in the restroom conducting business, things don’t flow as ... freely ... as they did in days of yesteryear. Just like reading glasses, it's another reminder that things aren't what they were when we were younger.
Prostatic enlargement is pretty much inevitable. Urinary symptoms associated with it are treated with pills called alpha-blockers which essentially enlarge the urethral channel by relaxing the muscle fibers within it. Other drugs called 5-alpha-reductase inhibitors actually shrink the gland by 1/3 of its size. If these pills don't keep you peeing straight and strong, there are also various procedures - some of them involve lasers! and trust me, you don’t want them described - that can remove the excess prostatic tissue. You can start with herbals like that of the woody shrub saw palmetto, pumpkin seeds (zinc), stinging nettle extract, pygeum, rye grass or beta-sitosterol extract and cruciferous vegetables (cauliflower, broccoli); but in randomized trials herbals can’t compare with prescription medication or procedures.
The prostate can also become inflamed, a condition called prostatitis, which occurs in about 10 percent of men at least once during their lives. This diagnosis is not subtle as most men with prostatitis pee firewater several times an hour. You can help prevent prostatitis by maintaining adequate hydration, practicing regular timed voiding and treating BPH when it occurs.
Fortunately, despite the fact that prostate cancer only rarely causes symptoms, most cases are caught early and are curable. Prostate cancer is very slow growing, doubling in size every 2-3 years. As such, a man is 8-10 times more likely to die of heart disease than prostate cancer. Many men have prostate cancer but never know it because something else ends up getting them first.
Genetics plays a role in the development of prostate cancer, but there are things you can do to prevent it. Following a heart-healthy, low animal fat, low carbohydrate diet is key to cancer prevention, as are exercise, weight management and stress reduction. Enjoy fruits and vegetables that are high in antioxidants to protect your body from cancer-causing oxidants. Soy and green tea may be especially good for the prostate. Eat more fish, a good source of omega-3 fatty acids. Obesity has been linked to prostate cancer so don’t pack on the lbs., and watch your sugar intake. The pills we mentioned earlier (5-alpha reductase inhibitors), used to slow BPH, can reduce the occurence of low-grade prostate cancer by 25 percent, so that’s convenient.
So, for various reasons, don't ignore the prostate. Attend to it before it disrupts the flow of your daily life (as well as the flow of your urine). That means taking great care of the body around it. The American Urological Association recommends screening for prostate cancer between the ages of 55 to 70 years (just a quick rectal exam, you got this!).